We report two patients with adenocarcinoma at angle of treitz who presented with upper GI(gastrointestinal) obstruction and underwent segmental resection of duodeno-jejunal junction. Preoperative investigations failed to reveal the nature of the lesion suggesting the elusive nature of these lesions, importance of clinical suspicion and decision-making.
INTRODUCTION:The laparoscopic surgeries though results in less postoperative pain it is not a pain-free procedure and early postoperative pain is the most dominant complaint which requires strong analgesia. This study assessed post-operative analgesia after intraperitoneal instillation of lornoxicam in laparoscopic appendicectomy. METHODS: This single blind randomized controlled trial was done in a tertiary care Centre of North Karnataka from January 2014 to December 2014. A total of 60 patients scheduled for laparoscopic appenticectomy were randomly assigned into two groups of 30 each (Group A and B) using computer generated random numbers. Patients in group A received intraperitoneal instillation of 8 mg lornoxicam (Diluted in 100 ml of normal saline) and in group B patients received 100 ml of intraperitoneal normal saline. During the post-operative period pain and requirement of analgesia were assessed. RESULTS: The demographic characteristics, clinical presentation and preoperative evaluation for vitals was comparable in group A and B. The mean VAS score were significantly low in group A compared to group B at fourth, sixth, eight and twelfth hour interval (p<0.050). In patients with group B, the requirement of analgesia was high (53.33%) compared to group A (33.33%) (p=0.118). CONCLUSION: The intraperitoneal instillation of lornoxicam is simple analgesic technique that reduces the pain without adverse effects compared to normal saline.
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